Acute abdominal pain; may be severe, and it can have any number of causes

May arise from the cardiac, pulmonary, gastrointestinal, hematologic, genital, urinary, reproductive, or other body systems

Abdominal Cavity

Located below the diaphragm and extends to the top of the pelvis

Peritoneum

Lines the abdominal cavity

Two layers: visceral peritoneum and the parietal peritoneum

The visceral peritoneum is the innermost layer and is in contact with the abdominal organs, whereas the parietal peritoneum is the outermost layer

Abdominal Aorta

The portion of the descending aorta that extends from the thoracic portion of the aorta to the distal point where the aorta divides into the iliac arteries. Arteries branching from the abdominal aorta supply the abdominal organs

Left Upper Quadrant (LUQ)

Contains most of the stomach, the spleen, the pancreas, and part of the large intestine. The left kidney is behind the abdominal lining

Right Upper Quadrant (RUQ)

Contains most of the liver, the gallbladder, and part of the large intestine. The right kidney is behind the abdominal lining

Right Lower Quadrant (RLQ)

Contains the appendix, part of the large intestine, and the female reproductive organs

Left Lower Quadrant (LLQ)

Contains part of the large intestine and the female reproductive organs

Solid Organs

Spleen

Liver

Pancreas

Kidneys

Hollow Organs

Stomach

Gallbladder

Duodenum

Large intestine

Small intestine

Bladder

Vascular Structures

The large blood vessels found in the abdominal cavity

Portions of the descending aorta and the inferior vena cava

Visceral Pain

Occurs when the organ itself is involved

Also associated with nausea and vomitting

Parietal Pain or Somatic Pain

Associated with irritation of the peritoneal lining

Pain more severe and more localized

Referred Pain

Visceral pain that is felt elsewhere in the body

Peritonitis

Irritation and inflammation of the peritoneum

Occurs when blood pus, bacteria, or chemical substances leak into the peritoneal cavity

Open wounds or sores within the digestive tract, usually in the stomach or the beginning of the small intestines. Associated with a breakdown of the lining that usually protects the intestine from the digestive fluids

Signs and symptoms: sudden onset of abdominal pain in the LUQ, nausea, vomiting, hematemesis, hematochezia, melena, signs or symptoms of shock, peritonitis with a rigid abdomen

Intestinal Obstruction

A blockage that interrupts the normal flow of the intestinal contents within the intestines

A protrusion or thrusting forward of a portion of the intestine through an opening or weakness in the abdominal wall. Most commonly associated with increased pressure in the abdominal cavity during heavy lifting or straining, causing the peritoneum to be pushed into the weakness or opening

Signs and symptoms: sudden onset of abdominal pain, fever, rapid pulse, tender mass at point of hernia, others similar to intestinal obstruction

Abdominal Aortic Aneurysm (AAA)

A weakened, ballooned, and enlarged area of the wall of the abdominal aorta